Bullock, Johnny
Bullock, Johnny is an individual health care provider with primary practice located at 62 Highway 587 , Foxworth MS 39483-5026. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Bullock, Johnny can be contacted via phone (601) 424-3540.Contact Information
Primary practice address
62 Highway 587
Foxworth MS 39483-5026
Phone: (601) 424-3540
Fax: (601) 424-3544
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 13883 | Mississippi |
Profile Details
| NPI number | 1043268709 |
|---|---|
| LBN Legal business name | Bullock, Johnny |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 5th, 2006 |
| Last updated | Nov 1st, 2012 - about 14 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1043268709 | NPPES |
| Mississippi | MEDICAID | 00737837 |
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